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WHO health briefing on Iraq

UN humanitarian briefing14 April 2003

Hospitals

An assessment team from the World Health Organization has conducted its first comprehensive survey of the situation in hospitals in the northern city of Kirkuk. The team, made up of two public health doctors, two pharmacists and one engineer, reports that the water and electricity infrastructure in the town is severely disrupted and that health facilities have been seriously damaged and disrupted by looting.

The team visited Azadi Hospital (which used to be called Saddam General Hospital), which is the main hospital in Kirkuk Governorate. They found only 40 patients in a 400-bed hospital, all with minor or moderate injuries. They concluded that there were two main reasons for this small number of patients: first, that in the current circumstances the chances of survival for anyone with a serious injury were very low; and second, that both health staff and patients had concluded that it was not safe to come to the hospital. Currently, between 50% and 75% of the health staff are not coming to work. Most have not been paid and there appears to be no system in place to pay them for the month of April.

There are two other hospitals in the town: a maternity and children's hospital, which was left largely intact; and the General Hospital, which was partially looted. Both hospitals are estimated to be running at about 25% of their normal capacity.

The work of those who are able to get to work at any of the hospitals is made extremely difficult by the fact that the main health storage facilities in the town have been completely emptied by looters. All medicines and medical supplies have been stolen and even the windows, doors and cooling system have been either stolen or destroyed. All health centres in the town have also been looted, as well as the local office of the Department of Health.

The WHO team was able to supply Azadi hospital with some urgently needed items, such as Oxygen cylinders. An agreement was reached to supply urgently needed medicines and other supplies.

This is only a snapshot from one town and WHO believes this situation is repeated across much of Iraq. Health facilities have been looted, vital supplies and equipment stolen, and both staff and patients are either afraid or unable to travel to the hospitals. Combined with the damage done to water and electricity systems, this makes the task of rehabilitation and reconstruction of the Iraqi health system harder than ever.

Health workers across Iraq clearly remain committed to their patients and their work: many continue to work in extremely difficult situation; some sleep in their hospitals or other workplaces; there have been many reports from Baghdad, Nasiriya and Basra of medical staff defending their hospitals and clinics against armed looters. However, unless conditions can be improved, even this level of dedication will not be enough to keep the system running.

WHO believes that the key tasks which have to be tackled immediately are:

Protection: health staff, patients, supplies and facilities must be protected from looting and threats.

Paying running costs: most hospitals are short of electricity and water. They need fuel - hundreds of litres a day - to power their generators so that the electricity works, operations can be undertaken, water is pumped in and sewage is removed. They must pay for this fuel in cash: they cannot get credit.

Meeting the living expenses of staff: this must be addressed urgently. Medical staff will not be able to continue working unless a system is put in place to provide them with the money they need to buy food for their families and to enable them to meet their daily living expenses.

Maintenance and cleaning: many hospitals have been damaged by conflict or looting; they need repairs and they must be kept clean.

Information on what is happening, where: this calls for rapid and continuing assessments. The needs are great and must be met. Accurate information is essential if supplies and other needs are to be prioritised - and met.

Medicines and medical supplies: much has been stolen; replacing medical stocks will be an urgent and vital need.